Sex-specific issues in eating disorders: a clinical and psychopathological investigation

  • Stefano ValenteEmail author
  • Giulia Di Girolamo
  • Martina Forlani
  • Anna Biondini
  • Paolo Scudellari
  • Diana De Ronchi
  • Anna Rita Atti
Original Article



To highlight the characteristics of eating disorders (ED) in males, with particular attention to sex-related clinical features and psychiatric co-morbidities.


Out of 280 persons, referred to our outpatients ED clinic between January 2011 and June 2014, 267 with complete information were included in this retrospective observational study.


The men/women ratio was one to five (male 16.5% vs female 83.5%) with an increasing proportion of male patients over the years. The most frequent ED in males was binge eating disorder, whereas in females anorexia nervosa and bulimia nervosa prevailed. Excessive exercising and fasting were the most common compensation behaviours in males; while self-induced vomiting and laxative–diuretic abuse were more typical in females. Among women, the most represented psychiatric co-morbidities were mood and somatoform disorders, whereas among men, anxiety and psychosis spectrum disorders were the most frequent ones. Borderline and histrionic personality disorders were prevalent in female ED, while narcissistic and antisocial personality disorders prevailed in males.


ED in men is a growing phenomenon. Male ED, compared to female ED, show differences in clinical presentation, symptoms and co-morbidities. Despite the use of clinical and psychometric evaluating tools targeting female patients, sex differences do exist and additional studies are required to investigate male specific issues in ED.

Level of Evidence Level V, cross-sectional descriptive study.


Sex Clinical features Personality disorders Eating disorders Clinical presentation Psychopathology 



We are grateful to all patients referring to our clinic for their constant collaboration and warm support. We are thankful to Diana Tassinari and Estefany Lopez for English revisions of the manuscript.

Compliance with ethical standards

Conflict of interest

Valente Stefano declares that he has no conflict of interest; Di Girolamo Giulia declares that she has no conflict of interest; Forlani Martina declares that she has no conflict of interest; Biondini Anna declares that she has no conflict of interest; Scudellari Paolo declares that he has no conflict of interest; De Ronchi Diana declares that she has no conflict of interest; Atti Anna Rita declares that she has no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of institutional committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Stefano Valente
    • 1
    Email author
  • Giulia Di Girolamo
    • 1
  • Martina Forlani
    • 1
  • Anna Biondini
    • 1
  • Paolo Scudellari
    • 1
  • Diana De Ronchi
    • 1
  • Anna Rita Atti
    • 1
  1. 1.Department of Biomedical and NeuroMotor Sciences-PsychiatryUniversity of BolognaBolognaItaly

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